Following is my Supplemental Directive. I do not consider it to be superior to any other, nor do I suggest that anyone copy it, though everyone is welcome to use any of it that suits their needs. I offer it merely as an example of what can be done. Referring to posts 1 through 3 on this topic should clarify the reasons for my choices. You will judge how well I have resolved the issues. I welcome ideas, critiques, and comments to improve my efforts.
“Over himself, over his own body and mind, the individual is sovereign.”
— John Stuart Mill
The United States Constitution and the common law (along with some state constitutions) give us the right to make directives that control the health services we receive if we become mentally incapacitated. The instructions provided by most states in the statutory forms that have been approved since the late 1980s do not limit us. We can write non-statutory directives I call “supplemental directives” when they are attached to and referenced in the statutory directives. We can also write our own health care directives without using statutory forms (an issue to be discussed in a subsequent post).
In Part 1 of this essay, I introduced two competing arguments concerning using advance directives to control what is done to our bodies should we become mentally incompetent.
As explained previously, the sole purpose of advance directives is to record one’s decisions about medical and related care if a person becomes unable to make such decisions later because of mental incapacity. To explain the range of options that are available both before and after such incapacity, I’ll use a personal example.
With this post, I begin a multi-part series that suggests how one might use advance directives to hasten one’s death to avoid inevitable, intractable suffering or an unacceptable loss of dignity, when the option of direct self-deliverance is unavailable or unwanted.
Usually, when we talk about suffering, we are thinking of physical suffering. But there are many people with severe, unresolved, debilitating mental illness who can find no relief from their suffering – suffering that is just as real (though its cause is different) as that experienced, for instance, by a patient at the end stages of pancreatic cancer, or a patient dying of metastasized prostate cancer. And none of the existing programs and services can help those with unrelenting mental illness die a peaceful death – a good death – to put an end to their suffering.
